Nan Maitland was an elegant 85-year-old retired occupational therapist who lived comfortably in Chelsea. She suffered from no apparent condition except a deteriorating case of arthritis. Calmly and determinedly she had decided that she would not put up with a life of pain and discomfort, “a prolonged dwindling” that she expected in the future. In February this year, she said her goodbyes and proceeded to Switzerland, booking herself into a clinic where she was assisted in ending her life.
The news of Ms Maitland’s death reignited the fierce controversy of assisted suicide that has raged in Britain for more than 80 years. It has been a continuous uphill struggle for the supporters of assisted suicide whose backers have presented no fewer than eight Bills or amendments to Parliament between 1936 and 2003. None have succeeded and a new attempt is under way with fresh proposals planned for autumn spearheaded by a Commission on Assisted Dying led by Lord Falconer.
It is clear that the issue of euthanasia is gathering steam. One recent poll carried out by the Society for Old Age Rational Suicide revealed that 66 per cent agreed that elderly people suffering from serious but non-fatal health problems should have the right to doctor-assisted suicide. Although by no means conclusive, there seems to be a shift in attitudes on the issue as more Britons seek a dignified death away from their country fearing prosecution for loved ones or medical professionals willing to assist.
There have been many controversies about the Swiss clinics for some time. Presently, there are two such clinics in Switzerland – the more well-known clinic established in 1998, Dignitas, and a smaller organisation called EX International, based in Bern. The disputes have been varied but not so much as when, in 2008, Dignitas acceded to assist in the suicide of Dan James, a 23-year-old former sportsman who had a permanent disability due to injury. This death raised many moral and ethical issues that rage on up to today.
Clearly, the issue of assisted suicide is a moral and ethical minefield. As with all deeply complex human issues, the debate for and against this process has its fierce supporters and detractors. Firstly, one must make it clear that, in the greater majority, most countries are adamantly against euthanasia. Assisted suicide in Europe is legal only in Belgium, Luxembourg, the Netherlands and Switzerland. In other countries, like Sweden, assisters are sometimes charged with manslaughter. In countries like France, that have strong palliative care systems, the issue is somewhat more subdued. In Italy, where euthanasia is strictly forbidden, the controversy rages on and there is continuous pressure for law reform with reservations.
Those for the case reinforce the argument that ending one’s life is a personal issue. Terminating a life of suffering is a humane act that allows the individual to pass on in a dignified and serene way avoiding the many complications surrounding terminal illness. Supporters of legalising assisted suicide insist it is a moral right and prerogative of the individual to freely choose to terminate his/her life clearly without causing any harm to others.
Those against, many of whom are medical professionals, believe there are extremely complex bioethical issues surrounding assisted suicide. Euthanasia may accelerate vulnerable states of mind in patients who are ill. The argument is best described as the “slippery slope”. Where does one draw a line when the procedure is to be made? Who should ultimately make such a decision? Is terminating a human being’s life contrary to what a health-care professional really represents? When one accepts premature death, what is the value of saving lives? What about the moral implications on the beliefs of medical practitioners? Many of these arguments are evidently powerful and make this issue even more complex.
Medicine and technology have achieved unimaginable progress in the last few decades. These developments have given us the power to save more and more lives. New discoveries in medicine through medical diagnostics, treatment and care have given hope to millions of patients who, until a mere 50 years ago, would have been impossible to treat successfully.
This has also made it possible for life to be sustained even when it seems hopelessly irreversible. It is claimed that, at the same time, this protraction, while seemingly compassionate, may result in unnecessary suffering for the patient. The onus of the obligation ultimately rests with our doctors who must make life and death judgements.
In Malta, the issue has been briefly raised in the past few years with very little in way of debate. Our religious background and pro-life culture may be reasons for this relative lack of interest in the issue. Our strong element of Christian fortitude and love of life may also be significant reasons for not rationalising life to such clinical and impersonal conclusions. Maybe, at least, this is one value we all agree upon!
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